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Marc Umlas 12/31/221/13/2021 City Commission 12/31/22 12/31/22 1/20/2021 1/20/2021 4/12/2021 4/12/2021 4/12/2021 4/12/2021 1AMIBE City of Miami Beach 1700 Convention Center Drive Miami Beach, Florido 33139 OFFICE OF TH E CITY CLERK Email: BC@mniamibeachfl.gov Telephone: 305.673.7411 AFFIDAVIT OF AFFILIATION WITH THE CITY OF MIAMI BEACH me.e9y Dude couNTY OF ALA 7 ¡ I am in compliance with the affiliation requirement of Miami Beach City Code Sections 2-22 (4) as (check (/) all that apply): »m a resident of the City of Miami Beach for six months or longer. ~ ~~ave an ownership interest (for a minimum of six months) in a business established in the City of Miami Beach (for a minimum of six months). D I am a full-time employee of a business (for a minimum of six months) and I am based in an office or other location of the business that is physically located in Miami Beach (for a minimum of six months). "Ownership Interest" means the ownership of ten percent (10%) or more (including the ownership of 10% or more of the outstanding capital stock) in a business. "Business" means any sole proprietorship, sponsorship, corporation, limited liability company, or other entity or business association. Under penalties df perjury, I declare that l have read the foregoing document and that the facts stated int are true. e -·. +las Date~ NOTARY Sworn to (or affirmed) and subscribed before me, by means of EX physical presence or [ online notarization, this 9th 4ay of April _,2021_by Marc Um las (City of Miami Beach Board/Committee Member). X Produced ID FL Drivers License Form of Identification Personally Known ala D'aeta Signature of Notary PuÉic Charles .J D'Agostin Name of Notary, Typed, Printed, or Stamped (NOT ARY SEAL) Charles J. DAgostin NOTARY PUBLIC STATE OF FLORIDA Comm# GG168171 ZS" Expires 12/14/2021 X Received on April 9, 2021Office of the City Clerk